AHA continues to push HHS on Medicare billing backlog

AHA and three member hospitals are suing the agency and in the latest court filing suggested methods for reaching a court-ordered 2020 deadline for getting through the claims.

By Les Masterson • Aug. 14, 2018

Telling doctors about their patients' opioid deaths curbed prescriptions

A letter from the San Diego County medical examiner resulted in lower high-intensity prescribing, fewer opioid prescriptions and overall lower opioid intake, according to an analysis.

By Les Masterson • Aug. 13, 2018

Primary care docs easier to find in ACA plans than Medicaid, study finds

Physicians are even more likely to participate in employer-sponsored health plans, according to the Health Affairs report.

By Les Masterson • Aug. 13, 2018

In first, FDA approves RNA interference drug from Alnylam

Alnylam's drug, called Onpattro, will carry an average annual list price of $450,000, although the biotech expects rebates to bring the net price down by a fifth.

By Ned Pagliarulo • Updated Aug. 10, 2018

FDA OKs marketing of contraceptive app

The Natural Cycles app has generated controversy in Europe, where women have reported unplanned pregnancies while using it.

By Susan Kelly • Aug. 13, 2018

CMS proposes Medicare ACO revamp to force risk

Proposed changes to the Medicare Shared Savings Program, a cornerstone of the Affordable Care Act, would force accountable care organizations to take on risk sooner. Critics fear this will chase participants out of the program.

By Tony Abraham • Aug. 10, 2018

Massachusetts fumbles on telehealth parity bill

Last year, the American Telemedicine Association gave the state an F on telehealth parity.

By Meg Bryant • Aug. 9, 2018

AMA charges CVS-Aetna deal would reduce competition

The analysis came as Bloomberg reported that the Justice Department won't oppose the merger based on vertical competition issues, although it may still be looking at how it will affect the pharmacy market.

By Les Masterson • Aug. 9, 2018

CHS under EHR meaningful use investigation

The Franklin, Tennessee-based provider is the latest to face scrutiny from federal investigators regarding the use of EHRs.

By Rebecca Pifer Parduhn • Aug. 9, 2018

CVS rejects pharma claim that rebates push up drug prices

Responding to charges that PBMs pocket much of drug rebates, the pharmacy giant said it retains only 2% of the price concessions from drugmakers. 

By Ned Pagliarulo • Aug. 9, 2018

ACOs using medical home physicians save money, yield higher quality, report finds

"ACOs and patient-centered medical homes are cut out of the same cloth," Robert Mechanic, executive director of the Institute for Accountable Care, said about the research.

By Rebecca Pifer Parduhn • Aug. 8, 2018

Small, medium payers show growing interest in provider-sponsored plans

A new white paper looked at that payer marketplace niche, which has seen significant turnover in the past five years.

By Les Masterson • Aug. 8, 2018

CMS to allow step therapy in MA plans in bid to boost price competition

Dan Best, CMS senior advisor for drug pricing reform, told reporters the policy could save 15-20% of the $12 billion annual spend by MA plans on oft-pricey Part B drugs. Not all analysts buy that estimate.

By David Lim • Aug. 8, 2018

Market concentration tied to higher premiums in ACA markets, study finds

Premiums in marketplaces with monopolist insurers were 50% higher than in markets with more than two insurers, according to a Health Affairs report.

By Meg Bryant • Aug. 7, 2018

CMS' Verma stands firm on 2015 EHR deadline, move to open APIs

Meanwhile, the coalition Health IT Now sent a letter to ONC chiding the government for failing to implement information blocking provisions of the 21st Century Cures Act.

By Meg Bryant • Aug. 7, 2018

Drugs make up more US health spending than thought, report suggests

Research published in Health Affairs found that drugs accounted for 15% of the country's total healthcare spending in 2016, higher than the oft-cited 10% figure.

By Ned Pagliarulo • Aug. 6, 2018

More employers look toward value-based insurance plans

After years of implementing cost-sharing policies like the use of high-deductible plans, businesses are looking for new avenues to reduce costs and improve health.

By Les Masterson • Aug. 6, 2018

CMS finalizes rule requiring hospitals to post prices online

The inpatient rule also cuts reporting periods down to 90 consecutive days, nixes the 25% threshold policy for long-term care hospitals and cuts a number of reporting measures.

By Tony Abraham • Aug. 3, 2018

Healthcare M&A remains hot, but value fell in Q2

Despite the activity, there was only one industry megadeal in the quarter — KKR's $10 billion buy of Envision.

By Les Masterson • Aug. 3, 2018

Opioid prescriptions aren't decreasing, study finds

The results come despite myriad attempts from lawmakers, providers and payers to curb opioid use, including prescribing and dosage restrictions.

By Les Masterson • Aug. 2, 2018

Final rule expands short-term health plans to 12 months

The plans can now have a maximum duration of a year, but can be renewed for a total of three years. HHS expects 600,000 people to enroll next year with as many as 6 million by 2022.

By Tony Abraham • Aug. 1, 2018

Unsubsidized coverage drops but individual market still stable

A Kaiser Family Foundation report found that about 2 million people dumped individual coverage over the past year, mostly middle-class Americans without subsidies to help control premiums.

By Les Masterson • Aug. 1, 2018

OIG fines eClinicalWorks for failing to report patient safety issues

The reporting requirement was part of a corporate integrity agreement originating from a $155 million settlement over falsification of EHR certification standards.

By Rebecca Pifer Parduhn • July 31, 2018

Patients often choose higher-cost locations for MRIs, study finds

Referring physicians have more influence over a patient's decision than out-of-pocket costs, according to the National Bureau of Economic Research report.

By Les Masterson • July 31, 2018

Industry split on CMS site neutrality proposal

Hospitals and health systems say site-neutral payments would hinder access for patients. Doctors and some policy experts argue that access shouldn't hinge on payment disparity. 

By Tony Abraham • July 31, 2018